RATIONALE: 4) To reduce the formation of oxalate calculi, urge the client to avoid foods high in oxalate, such as spinach, rhubarb, and asparagus. Other oxalate- rich foods to avoid include tomatoes, beets, chocolate, cocoa, celery, and parsley.
Citrus fruits, molasses, dried apricots, milk, cheese, ice cream, sardines and organ meats do NOT produce oxalate and do NOT need to be omitted from the client's
diet.
RATIONALE: 2) Disequilibrium syndrome is caused by a rapid reduction in urea, sodium, and other solutes from the blood. This may lead to cerebral edema and increased intracranial pressure (IICP).
S/S of ICCP include HA, nausea, and restlessness as well as vomiting, confusion, twitching, and seizures.
Fever and elevated WBC may indicate infection.
Popping or ringing in the ears, chest pain, dizziness, or coughing suggests an air
embolus.
Chest pain, dyspnea, burning at the access site and cramping suggests acute hemolysis.
Renal System- INSPECTION:
SKIN: pallor, yellow-gray cast, excoriations, changes in turgor, bruises, texture (e.g., rough, dry skin)
MOUTH: stomatitis, ammonia breath odor
FACE & EXTREMITIES: generalized edema, peripheral edema, bladder distention, masses, enlarged kidneys
ABDOMEN: striae, abdominal contour for midline mass in lower abdomen (may
indicate urinary retention) or unilateral mass (occasionally seen in adult, indicating enlargement of one or both kidneys from large tumor or polycystic kidney)
WEIGHT: weight gain secondary to edema; weight loss and muscle wasting in renal failure
GENERAL STATE OF HEALTH: fatigue, lethargy, and diminished alertness
dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts, celery, parsley, runner beans, chocolate, instant coffee, Ovaltine, tea, worcestershire sauce
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